Aydin Alper, Gurol Tayfun, Soylu Ozer, Dagdeviren Bahadir
Bahcesehir University School of Medicine, Department of Cardiology Istanbul, Turkey.
Int J Cardiol Heart Vessel. 2014 Mar 19;3:60-63. doi: 10.1016/j.ijchv.2014.03.002. eCollection 2014 Jun.
At present, there are no definite criteria for selecting patients eligible for same-day discharge after percutaneous coronary interventions (PCI). With rapid ambulation and reduced vascular complication rates, transradial PCI have many features that favorably reduce costs and hospital stay. This study aimed to demonstrate the possibility of early ambulatory discharge following transradial percutaneous coronary interventions.
254 consecutive patients undergoing transradial PCI (elective, urgent, and emergent) at our center was observed during hospital stay. Patient demographics, angiographic characteristics, post-procedural complications, and timing of these post-procedural events were recorded.
A total of 336 lesions were treated among 299 vessels with 277 stents. One hundred fifty-two (45.2%) lesions were Type C. There were 26 chronic total occlusions (CTO). One hundred fifty-five (61%) patients were discharged on the same day after the procedure. 24 complications (12.6%) occurred and were divided into three groups according to occurrence time. 13 (54.2%) occurred within the first 2 h and 11 (45.8%) occurred after the 24-hour period. No complications were observed between the 2nd and 24th hours.
Same-day discharge with a 2-hour observation period is safe and feasible after successful transradial PCI in appropriate patients. Although a minor number of complications occurred, these did not occur between the 2nd and 24th hours. Same-day discharge after successful transradial PCI could be an alternative for better utilization of resources.
目前,对于经皮冠状动脉介入治疗(PCI)后符合当日出院条件的患者,尚无明确的选择标准。经桡动脉PCI具有能让患者快速活动及降低血管并发症发生率的特点,在降低成本和缩短住院时间方面有诸多优势。本研究旨在证明经桡动脉PCI术后早期活动出院的可能性。
对在我们中心连续接受经桡动脉PCI(择期、紧急和急诊)的254例患者的住院期间进行观察。记录患者的人口统计学资料、血管造影特征、术后并发症以及这些术后事件的发生时间。
共治疗299支血管中的336处病变,植入277枚支架。152处(45.2%)病变为C型。有26处慢性完全闭塞(CTO)病变。155例(61%)患者术后当日出院。发生24例并发症(12.6%),并根据发生时间分为三组。13例(54.2%)发生在最初2小时内,11例(45.8%)发生在24小时之后。在第2小时至第24小时之间未观察到并发症。
对于合适的患者而言,经桡动脉PCI成功后,进行2小时观察期的当日出院是安全可行的。尽管发生了少量并发症,但这些并发症并未在第2小时至第24小时之间出现。经桡动脉PCI成功后的当日出院可能是更好利用资源的一种选择。